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McCain’s Plan Bests Obama’s

For some time now, the debate over how best to reform the
American healthcare system has been dominated by the question of
“universal coverage,” how to provide health insurance to those
without it. However, if Sens. John McCain (R-Ariz.) and Barack
Obama (D-Ill.) become the candidates for president this fall, we
may see a subtle but useful shift that could actually lead to
improving how healthcare is provided in this country.

Throughout the primaries Sen. Hillary Rodham Clinton (D-N.Y.)
and Obama have clashed over the question of an individual mandate
(requiring every American to purchase insurance). Hillary supports
such a mandate, claiming that it’s the only way to ensure universal
coverage. Obama opposes one, arguing that “the reason people don’t
have health insurance is not because they don’t want it; it’s
because they can’t afford it.” Instead of a mandate, therefore,
Obama would focus on a combination of cost cutting and subsidies to
reduce the price of insurance. While he believes that his proposal
would greatly increase the number of Americans with insurance, he
admits it will fall short of 100 percent coverage.

McCain’s proposal is much
more consumer-centered and taps into the best aspects of the free
market.

McCain also puts cost control before universal coverage.
“Bringing costs under control is the only way to stop the erosion
of affordable health insurance,” McCain says. A McCain spokesman
adds, “You worry about the uninsured, but they are a symptom of a
larger problem. Unless you do something about cost, you are chasing
your proverbial tail.”

That is not to say that Obama and McCain agree on how to reduce
healthcare costs. Obama would rely much more on the heavy hand of
government. Among other things, he would impose caps on insurance
premiums and price controls on drug companies. He would have the
government establish national practice standards for doctors. And,
he would create a National Health Insurance Exchange as a sort of
clearinghouse to make it easier for businesses and individuals to
shop for the best insurance.

McCain, in contrast, would attempt to promote greater
competition among private health insurers.

He would allow people to buy insurance plans across state lines,
which will help drive down rates. And he would try to shift away
from our current employment-based insurance system toward a system
where individuals purchase and own their own insurance plans. He
would do this by replacing the current tax break for
employer-provided insurance with a refundable $2,500 tax credit for
individuals, and $5,000 for families. The idea is that once people
start to buy their own insurance, they’ll be in a position to
insist on lower prices and higher quality - just as they do with
every other product they buy.

Overall, McCain has the better proposal. Obama’s plan, with its
heavy reliance on government, leads to the same problems that
bedevil universal healthcare systems all over the world: limited
patient choices and rationed care. McCain’s proposal is much more
consumer-centered and taps into the best aspects of the free
market.

But regardless of who becomes president, we can expect major
changes for the American healthcare system. And it’s a good sign
that we’re beginning to debate the right things.